Isolating the Healthy & Not the Virus is A Failed Action

Slowing the rate that bullets are fired and still hit us, doesn’t avoid the threat they pose. We survive COVID-19 bullets by getting out of  harm’s way and then neutralizing the threat. 

Getting out of harms way is done by isolating potential victims, similar to school children being sheltered-in-place during an active shooter attack. It slows, but does not stop the threat. Lockdowns are a necessary short term action until an effective response to neutralize the threat arrives. Lockdowns without neutralizing the threat, inevitably inflicts harm and deaths upon those it is our duty to protect. 

Neutralizing the threat of COVID-19 has been effectively done in countries with rapid and extensive testing, contact tracing for further testing, and isolating carriers of the virus, asymptomatic or otherwise. Some nations have virtually eliminated infections despite being hotspots early on (such as China), and others were so proactive with testing and tracing, that they never had outbreaks get seriously out of control; such as Vietnam, South Korea, Taiwan, and New Zealand to name a few.

Nations which have not given a priority for fast and accurate testing along with effective contact tracing are those doing poorly in handling their crisis response. Most western countries, including Canada, have opted to focus efforts in ongoing isolation of the healthy and spending on various patchwork and imbalanced support programs for the economy while awaiting the development, approval and dissemination of vaccines. This is an approach that makes the crisis have a longer duration and with an increasing magnitude in the meantime. While it is true Canada does tests, waiting days to obtain one and then days more for results, after long delays in contact tracing notifications, public health is not being properly served with fast, widely available testing and prompt isolation of virus carriers.  It is a failure ignored in most mainstream media discussions. 

Our hospital emergency rooms and ICU units are strained, exposing the cracks of how underfunded and understaffed they were before this crisis. Professional health care workers are at their wits end, even as we enter the second and larger wave. As of mid November 2020, Canada has had 11,000 deaths from 300,000 cases of infection with a full third of those occurring in the last month. We are adding 5,000 new cases per day and are on a trajectory of adding 20,000 to 60,000 cases per day be years end. Hospitals are approaching maximum capacity using up all ICU beds. Soon, this virus will overwhelm our ability to treat COVID-19 or any other pressing health care matter, in which hospitals will be faces to decide who gets care and who does not. There is a very informative video lecture by Professor David Lepofsky on critical medical care triage protocol that the Ontario Government sent to hospitals in case the COVID-19 pandemic overloaded hospitals, requiring rationing of critical care. He mostly addresses concerns relating to those with disabilities, though it affects all of us. 

 

 

Many of the deaths so far have occurred in Long Term Care facilities, which have also been understaffed and underfunded for many years before this virus crisis. The military stepped in to help with staff shortages, only to find residents left in bed with soiled diapers, forced feeding of residents or missed meals, and lack of cleaning that resulted in insect infestations, such as bed bugs. Instead of ensuring improvements in that sector, the Ontario government’s response was to pass Bill 218 on November 16th, which indemnifies for-profit long-term care homes (among others) for liability in their negligence during the pandemic. Better care has been legislated to begin – FIVE years from now. As for this year, Premier Doug Ford has cut $100 million from the public LTC homes, while the privately operated LTC centres have given $59 million to shareholders in this quarter alone. It appears that individuals in LTC facilities are considered not as important as the lives of some others.

Almost a full year since the outbreak began, we still have no national COVID-19 response strategy. No large scale, fast, and accurate testing available. Contact tracing infrastructure is inadequate. Sadly, these most effective tools to stop the spread of the virus are being marginalized while our leaders primarily focus on colour-coded scales of lockdowns. These orders are getting harder to follow as many citizens are experiencing “COVID fatigue” of mitigating risks. Many meet in larger numbers than they should, closer than they should, and fail to use face masks as they should. People are restless because they should have been rescued by now with what works. Testing. Tracing. Containment of the threat. Not just told to shelter-in-place while it gets worse and worse, with more and more deaths.

Some people believe the virus is a hoax – it is overblown or being used by the government to condition citizens to surrender civil liberties. They actively engage in super spreader events or protests such as “Hugs over masks”. They argue the numbers are low, oblivious to where exponential growth will take us weeks from now if they aren’t kept low. In a sense, they are screaming for their freedom to move into the active shooter’s path. This, at a time when rates of infection in Canada are skyrocketing with ominous predictions.

Absent better testing and tracing, viral spread will continue until we get herd immunity with the majority getting infected or by large scale vaccinations. Letting it burn through our communities is not acceptable. 

A vaccination program is like trying to take away all the ammunition for the guns on the street knowing that people are still being shot right now. Unfortunately, this strategy takes more time and is more costly than large scale testing and contact tracing would have been. Medical associations, education and research centres are greatly influenced by their financial backers – big pharmaceutical companies – whom I believe have used direct and indirect influence for ongoing community shutdowns for us to await the vaccines that will make pharmaceutical companies huge profits, provided they are released before everyone has already caught the virus.

The Canadian government has spent billions in rapid research with contracts given to seven different pharmaceutical companies and said this allows us to obtain up to 414 million doses of vaccine, depending upon which are approved by Health Canada. As of mid November 2020, Pfizer and Moderna each claim forthcoming vaccines (95% effective) which are in the third stage of clinical trials. It is anticipated that vaccines should be available for Canadians in the spring of 2021; but we have only secured 6 million doses. Each person receiving the vaccine will need two doses, so this supply will serve less than 1/10th of the population. There are other companies with promising candidates; but, it does not appear we will be doing mass inoculations before late summer of 2021. It is clear that social, medical and economic disasters will be our companions for quite a while – unless we start to get serious on testing, tracing and containing the virus.

Why did we lock down and wait for vaccines rather than do the large scale testing that would have already stopped the spread of the virus? We have seen it is possible in other countries without a vaccine, faster and cheaper to tax payers. While it may not be our government’s plan is to do whatever will make the pharmaceutical companies the most money at our expense, it seems they are at least willing to see it be done that way.

Delayed effective response has made the wealthiest, like Jeff Bezos, become wealthier and some corporations (such as his Amazon) are making record profits. Government has given billions of dollars to other major businesses not doing as well, while many small businesses are struggling and often collapsing due to the lockdowns. This has accelerated the shift of wealth from all the little guys to the few big guys. Various patchwork supports for individuals have allowed many to fall through the cracks. Experts calling for a more effective across-the-board Guaranteed Liveable Income for all individuals has been as ignored.

As we look back at the failures in handing this crisis, we should take a moment to consider how this crisis could have been avoided as a global catastrophe. Canadians I have spoken with are largely unaware of information contained in the Globe and Mail article entitled “What happened with Canada’s pandemic alert system? The GPHIN controversy explained”. In brief, Canada had an international pandemic alert system called the Global Public Health Intelligence Network, which was praised by the United Nations as the gold standard nearly 30 years ago. Amongst other successes, our agency sounded the alarm for the Ebola threat in Africa and took leadership in containing the outbreak and preventing deaths globally. Stephen Harper’s Conservative government cut the $20 million annual funding of the program to the verbal outrage of Justin Trudeau, whom later became Prime Minister and did not refund nor restore its functioning. We would have undoubtedly benefited had this agency been operational as the Covid-19 pandemic began.

It is clear that we desperately need a national COVID-19 strategy developed by all parties at the table with non-partisan collaboration for best outcomes. It is a failure to all Canadians to not have done so by now. Our government has failed to provide widely available testing, effective contact tracing and containment of the virus. We are using what should have been a short term lockdown as our main course, while awaiting vaccines, which are coming too slowly or too late for many lives, and with very high costs in many ways for all of us.